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Manitoba health minister blames cabbies after discharged patients die on their own doorsteps

Manitoba health minister blames cabbies after discharged patients die on their own doorsteps

Who dropped the ball, or should I say balls, when two men died on their own doorsteps after being sent home from a Winnipeg hospital in taxis?

Manitoba Health Minister Erin Selby seems to think it's the cabbies.

"No one's expecting cab drivers to make medical decisions. It's up to doctors to determine whether or not somebody is safe and healthy enough to go home," CBC News reported her saying.

"All we are asking is to formalize what is already happening in many, many cases ... just an extra pair of eyes on someone to make sure they make it through the front door."

Really? Let's just think about that for a minute.

Last month, staff at Grace Hospital released 78-year-old David Silver and put him in a cab. He died on the front porch of his home from what health officials said was a heart-related health complication, CBC News said.

A day later, 62-year-old Wayne Miller, who suffered from a major aneurysm (a potentially fatal ballooning of a blood vessel) and was awaiting admission to palliative care, was sent home from Grace Hospital by himself in a taxi. He was found unconscious on the sidewalk less than an hour later and died before paramedics arrived.

If only the taxi drivers had been there, had escorted them into their homes. They'd have been OK, right?

“I think it’s the most inane, asinine thing I’ve heard in my life,” Wayne Miller's brother, John, told CBC News.

Of course it is. Pointing a finger at taxi drivers deflects attention from the question of why these two men were discharged from hospital in the first place.

If someone is so ill that they die before making it to the front door, how would having the driver escort them have helped? Isn't it just as likely they would simply have expired inside the house?

The incidents surfaced in the midst of an inquest into the 2008 death of Brian Sinclair. The aboriginal wheelchair-bound double-amputee died of a treatable bladder infection in the Winnipeg Health Sciences Centre's emergency room after spending 34 hours awaiting care and largely ignored by staff.

[ Related: Nurse thought Brian Sinclair was intoxicated, inquest told ]

The Winnipeg Regional Health Authority is investigating whether proper hospital discharge protocols were followed in last month's incidents, CBC News said.

It also met with the city's Taxicab Board to work out a new protocol for delivering discharged patients home.

"Making sure someone gets home safely when the decision is made to discharge a patient will also be looked at," Selby echoed in her statement on the deaths.

"The [health authority] will be working with the taxi cab drivers to ensure cab drivers watch to make sure that patients they drive home, who are safely discharged, get inside their home. We'll be working to get this in place as soon as possible."

It's a courtesy certainly, and probably common sense, for a driver to escort someone who looks fragile into their home. But the onus for the patient's safety surely lies elsewhere.

Taxicab Board chairman Bruce Buckley worries about cabbies' responsibility and potential liability.

"How do you protect them if somebody slips and falls, for example?" he told CBC News. "They're not health-care aides, they are drivers."

It really comes back to the hospital's discharge protocol.

"The decision to discharge is done in consultation with patients and is done based on clinical judgment," health authority spokeswoman Bronwyn Penner-Holigroski told the Winnipeg Free Press.

"All significant safety concerns raised by patients, families, team members or others must be addressed prior to discharge."

The Free Press said health authority patient-discharge guidelines require that anyone who needs assistance with transportation or to get into their home and be there safely "must have a named and available support person contacted, confirmed and documented by the ED [emergency department] nurse or emergency physician/nurse practitioner before being discharged."

Investigations into the deaths of the two men presumably will reveal whether those requirements were met.

[ Related: Blind B.C. hospital humiliation victim gets apology from premier ]

The incidents in some ways resemble the case last fall of Vivian Fitzpatrick. The legally blind 90-year-old Delta, B.C., woman was discharged from Delta Hospital and put in a cab a 2:30 a.m. in her pyjamas-fabric hospital slippers after being seen in the ER for high blood pressure.

Although she had a caregiver waiting at her home, no one was notified she was being discharged, including her daughter who was the emergency contact, CTV News reported at the time. On the cab ride home Fitzpatrick, wrapped only in a sheet, began bleeding from an intravenous puncture in her arm.

The local health authority apologized and Fitzpatrick's daughter said officials blamed the incident on a junior nurse.

The cabbie who took her home? In the clear.